In Lucknow, medical experts have raised serious concerns about thyroid disease management, revealing that nearly 40-50% of patients fail to achieve proper disease control. This alarming statistic emerged during interactions held as part of Thyroid Awareness Month, with doctors attributing the problem primarily to poor medication compliance and widespread lack of awareness about correct drug intake protocols.
Understanding Thyroid Disorders: Two Main Types
Doctors explained that thyroid disorders broadly fall into two categories. Hypothyroidism occurs when the thyroid gland produces insufficient hormones, slowing down body functions and typically requiring lifelong medication. Conversely, hyperthyroidism results from excessive hormone production, accelerating bodily processes and causing symptoms like rapid heartbeat, unexplained weight loss, and noticeable tremors.
Prevalence and Risk Factors
Dr. Avivar Awasthi, an endocrinologist at Ram Manohar Lohia Institute of Medical Sciences (RMLIMS), highlighted that thyroid disorders affect 10-15% of the general population, with higher prevalence among women and high-risk groups including individuals with hypertension and diabetes. He emphasized that hypothyroidism accounts for the majority of thyroid disorder cases.
Dr. Awasthi further clarified that hypothyroidism can be either subclinical or clinical. While mild cases might not require immediate treatment initially, once medication begins, it typically needs to continue throughout the patient's lifetime. A common and serious mistake is stopping medicines once test reports become normal. The report is normal because the patient is taking the medicine — the body itself is not producing enough hormone, he cautioned.
Critical Medication Mistakes Compromising Treatment
Medical professionals identified several critical errors that contribute to treatment failure. Incorrect timing of medication ranks among the biggest reasons for poor outcomes. Thyroid tablets must be taken early morning on an empty stomach, maintaining a minimum gap of one hour before consuming any food.
Dr. Sakshi Gagneja, consultant in endocrinology at Apollo Hospitals, confirmed that nearly 40-50% of patients demonstrate suboptimal thyroid control because they take their medicines incorrectly. Many patients keep only a 30-minute gap or eat immediately after taking the tablet, which significantly reduces its effectiveness, she explained.
Storage and Administration Errors
Dr. Sushil Gupta, principal director and head of endocrinology and diabetes at Max Superspecialty Hospital, highlighted additional problems. Storing pills in humid bathrooms, near heat or light, missing doses, or frequently switching brands can reduce drug potency and absorption, he warned.
Dr. Manish Gutch, director of diabetes care at Medanta Hospital, elaborated on the consequences. These mistakes lead to poor disease control, frequent dose changes and long-term complications, he said, adding that irregular intake or self-adjusting doses increases the risk of fatigue, weight gain, and heart disease.
The Impact of Diet and Treatment Discipline
Dr. Awasthi emphasized that diet and storage habits significantly influence thyroid control. Certain foods including cabbage, cauliflower, spinach, capsicum, soy, and soybeans can interfere with thyroid hormone production when consumed raw. These foods need not be avoided, but should be well cooked. Consuming them raw, especially as salads, can reduce treatment effectiveness, he advised.
Regarding hyperthyroidism, Dr. Awasthi identified the most common mistake as stopping medicines without medical advice. He noted that 50-70% of hyperthyroidism cases result from Graves' disease, and medication withdrawal is possible only in selected patients under strict specialist supervision.
Patients undergoing treatment for over five years should consult specialists about permanent options such as surgery or radioiodine therapy.
Life-Threatening Consequences of Poor Control
Dr. Sakshi Gagneja warned that poorly controlled or untreated hypothyroidism can cause multiple complications:
- Persistent fatigue and unexplained weight gain
- Chronic constipation and elevated cholesterol levels
- Infertility issues
- Impaired fetal brain development during pregnancy
In severe cases, it can progress to myxedema coma, a potentially life-threatening condition.
Uncontrolled hyperthyroidism presents different dangers:
- Irregular heart rhythm and palpitations
- Noticeable tremors and thyroid eye disease
- Increased risk of heart failure and osteoporosis
- During pregnancy, higher risk of fetal loss and intrauterine growth restriction (IUGR)
Dr. Gupta cautioned that stopping drugs prematurely or continuing them without proper monitoring raises the risk of dangerous heart rhythm disorders, bone loss, and medical emergencies such as thyroid storm.
Dispelling Common Myths About Goitre
Addressing a widespread misconception, Dr. Awasthi clarified that thyroid swelling (goitre) does not shrink with medicines. There is no tablet that can reduce the size of an enlarged thyroid. Treatment options include surgery, needle-based procedures, or specialised heat-based techniques, he explained.
The collective medical advice underscores the importance of proper education, disciplined medication practices, and regular specialist consultations for effective thyroid disorder management. As Thyroid Awareness Month highlights these issues, healthcare professionals hope increased understanding will help more patients achieve better disease control and avoid preventable complications.
